Drilldown: Medicines

None (4) · Bisoprolol (1) · Memantine ER / Donepezil (1) · Nebivolol (1)

Belsomra (1) · Botox (1) · Bystolic (1) · Dayvigo (1) · Namzaric (1) · Quviviq (1) · Zebeta (1)

Beta Blocker (2) · Cardioselective (β1) (1) · Cardioselective (β1) + vasodilator (1) · Combined cholinesterase inhibitor + NMDA antagonist (1) · Dual orexin receptor antagonist (DORA) (3) · neuromuscular blocker (presynaptic) (1) · Neurotoxin (1) · the first approved (1)

None (1) · Cleaves SNAP-25 protein in presynaptic motor and autonomic nerve terminals, blocking acetylcholine release; in chronic migraine, hypothesized to inhibit peripheral sensitization of trigeminovascular nociceptors (1) · Competitive antagonist at OX1R and OX2R. Faster receptor association/dissociation kinetics than suvorexant (~16 sec dissociation vs ~57 sec) hypothesized to support sleep onset, with sufficient duration for maintenance. (1) · Competitive antagonist at OX1R and OX2R. First-in-class DORA. Receptor dissociation slower than lemborexant or daridorexant. (1) · Donepezil: reversible AChE inhibitor, increases synaptic acetylcholine. Memantine: uncompetitive low-affinity NMDA receptor antagonist, dampens pathological glutamate overactivation while preserving normal synaptic signaling. Targets two distinct mechanisms in Alzheimer's. (1) · Highly β1-selective adrenergic antagonist. Greater selectivity than metoprolol or atenolol. (1) · The d-enantiomer is a highly β1-selective antagonist; the l-enantiomer triggers endothelial nitric-oxide–mediated vasodilation. Unique among beta blockers for this NO mechanism. (1)

Chronic migraine (≥15 headache days/month), cervical dystonia, blepharospasm, hyperhidrosis, overactive bladder, urinary incontinence, strabismus, spasticity, cosmetic problems (1) · Insomnia (sleep onset and/or maintenance) in adults (FDA-approved August 2014). Also studied for insomnia in mild-moderate Alzheimer disease. (1) · Insomnia (sleep onset and/or maintenance) in adults (FDA-approved Dec 2019) (1) · Insomnia (sleep onset and/or sleep maintenance) in adults (FDA-approved Jan 2022) (1) · '"`UNIQ--vote-00000468-QINU`"' (1) · '"`UNIQ--vote-0000059D-QINU`"' (1) · '"`UNIQ--vote-00000636-QINU`"', '"`UNIQ--vote-00000637-QINU`"', '"`UNIQ--vote-00000638-QINU`"' (1)

10 mg PO 30 min before bedtime (with ≥7 hours of sleep planned) (1) · 2.5–5 mg daily (HTN); 1.25 mg daily (HFrEF, slow titration) (1) · 25 mg PO at bedtime (no titration); may increase to 50 mg if 25 mg inadequate (1) · 5 mg daily (1) · 5 mg PO at bedtime; may increase to 10 mg if inadequate (1) · Chronic migraine (PREEMPT protocol): 155 units divided across 31 sites in 7 head/neck muscle groups every 12 weeks (1) · For patients already stable on memantine 28 mg/d + donepezil 10 mg/d, switch to one capsule daily of equivalent strength (1)

2.5, 5, 10, 20 mg tabs (1) · 25 mg, 50 mg tablets (1) · 5 mg, 10 mg tablets (1) · 5 mg, 10 mg, 15 mg, 20 mg tablets (1) · 5, 10 mg tabs (1) · 50, 100, or 200 unit vials of lyophilized powder for reconstitution (1) · 7/10, 14/10, 21/10, 28/10 mg ER capsules (memantine ER / donepezil) (1)

10 mg/d (1) · 195 units/treatment for chronic migraine; max varies by problem (1) · 20 mg/d (2) · 28/10 mg/d (1) · 40 mg/d (1) · 50 mg/d (1)

Intramuscular (PREEMPT injections for migraine) (1) · Oral (5) · Oral (capsule whole or opened/sprinkled on applesauce) (1)

1–2 h (2) · 1–2 weeks for muscle effects; preventive migraine benefit accrues over 12-week cycles (1) · Component effects accumulate over weeks (1) · ~30 min (3)

None · 24 hours · 4-6 hours · 12 hours · 6-8 hours · Daily dosing · 8-12 hours · 12-24 hours · Hours · Hours per application · 24 hours (HS dosing) · 24 hours (once-daily dosing) · 24 h · N/A · N/A (replacement) · Variable · ~7-8 hours · 3-5 hours · 4-6 hours (IR); 24 hours (ER) · 6-12 hours

Other values:

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9–12 h (1) · Tissue half-life not formally measured; clinical effect ~12 weeks (1) · ~10 h (CYP2D6 extensive metabolizers); up to 31 h (poor metabolizers) (1) · ~12 hours (1) · ~17-19 hours (longer than daridorexant) (1) · ~60–80 h (memantine); ~70 h (donepezil) (1) · ~8 hours (shorter than suvorexant and lemborexant) (1)

Local (intramuscular) (1) · ~100% both components (1) · ~12% (extensive metabolizers); ~96% (poor metabolizers) (1) · ~44% (1) · ~62% (1) · ~82% (1) · ~90% (low first-pass) (1)

Category C (2) · Category C; limited data (1) · Limited data; avoid (3) · Not relevant (geriatric problem) (1)

Rx, Schedule IV (US) (3) · Rx-only in US (3) · Rx; black-box warning for distant spread of toxin effect (1)